Prospective observational study of the practice of endotracheal intubation in the emergency department of a tertiary hospital in Sydney, Australia. įogg T, Annesley N, Hitos K, Vassiliadis J. 2011 106: 632-42.Īustralasian College for Emergency Medicine. Part 2: intensive care and emergency departments. Major complications of airway management in the UK: results of the fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Tracheal intubation in the critically ill: a multi-Centre national study of practice and complications. © 2021 Australasian College for Emergency Medicine. In our setting, checklist use was associated with fewer complications.Īirway intubation rapid sequence intubation safety. Implementation of an evidence-based care bundle and audit of practice has created a safe environment for trainees to learn the core critical care skill of RSI. Logistic regression found checklist use was associated with reduced desaturation (OR 0.1, 95% CI 0.04-0.27) and the composite variable of any complication (OR 0.39, 95% CI 0.17-0.89). Complications were reduced with checklist use (13.3% vs 43.2%, P < 0.001) and apnoeic oxygenation use (3.9% vs 31.1%, P < 0.001). FPS improved with bougie use (88.9% vs 73.0% without bougie, P < 0.001) and video-laryngoscopy (88.2% vs 72.9% using standard laryngoscopy, P < 0.001). Complications were reported in 15.9%, mainly hypotension (10.9%) and desaturation (4.0%). Six hundred and fifty-five patients underwent RSI with FPS of 86.6%. Descriptive statistics and multivariable modelling were used to describe differences in FPS, and complications. Data collected included: first-pass success (FPS), predicted difficulty, indication for intubation, drugs used, positioning, number of attempts, checklist use and complications. Prospective observational study of RSIs performed in the EDs of two Queensland hospitals between January 2014 and December 2016. ![]() We aimed to improve patient outcomes by implementing an RSI checklist, electronic learning and audit, in line with current best evidence. Emergency medicine trainees are exposed to relatively low numbers of RSIs. Rapid sequence intubation (RSI) is a core critical care skill.
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